Rawatan untuk Penagih Dadah

    Rawatan dan pemulihan dadah yang berkesan seharusnya berasaskan kepada beberapa prinsip dan panduan antaranya seperti tiada rawatan tunggal yang sesuai untuk semua individu. Treatment setting, intervensi dan perkhidmatan yang disediakan hendaklah dipadankan dengan masalah dan keperluan tertentu klien untuk memastikan kejayaan mengembalikan fungsi produktifnya dalam keluarga, tempat kerja dan mayarakat. Kemudahan rawatan perlu sentiasa ada untuk memberi pertolongan kepada klien apabila ia memerlukan. Oleh kerana tidak dapat dipastikan bila penagih dadah akan tampil untuk mendapat rawatan, ambil kesempatan apabila ia bersedia untuk mengikuti rawatan kerana ia mungkin akan menghilangkan diri atau meneruskan aktiviti penagihannya jika kemudahan rawatan tidak disediakan serta merta atau tidak ada sepanjang masa. Kemudahan rawatan hendaklah mengambil kira pelbagai keperluan klien dan bukan memberi tumpuan kepada masalah penggunaan dadah semata-mata. Supaya menjadi berkesan, rawatan seharusnya memberi perhatian bukan sahaja terhadap masalah penggunaan dadah tetapi juga terhadap apa-apa masalah berkaitan dengan perubatan, psikologi, sosial, spiritual, vokasional dan undangundang. Rancangan rawatan dan perkhidmatan untuk klien mestilah dinilai secara berterusan dan dimodifikasikan apabila perlu untuk memastikan rancangan tersebut memenuhi keperluan klien untuk berubah. Klien mungkin memerlukan kombinasi perkhidmatan dan komponen rawatan yang berbeza semasa menjalani rawatan dan pemulihan. Dari perspektif terapi, klien pada satu masa mungkin memerlukan ubat-ubatan, perkhidmatan perubatan yang lain, terapi keluarga, kemahiran keibubapaan, pemulihan cara kerja, perkhidmatan sosial dan undang-undang. Perlu disedari bahawa pendekatan rawatan hendaklah bersesuaian dengan tahap umur, jantina, bangsa dan amalan budaya klien. Berada dalam rawatan untuk tempoh masa yang cukup adalah penting untuk keberkesanan rawatan. 

    Tempoh masa berada dalam rawatan yang bersesuaian untuk klien adalah bergantung kepada masalah dan keperluannya. Kajian menunjukkan kebanyakan klien mencapai garis masa perubahan yang signifikan setelah berada selama 3 bulan dalam rawatan. Selepas garis masa ini dicapai, rawatan tambahan boleh menghasilkan kemajuan selanjutnya ke arah kepulihan. Oleh kerana klien selalu meninggalkan rawatan sebelum masanya, program rawatan seharusnya melibatkan strategi untuk mengikat dan mengekalkan klien dalam rawatan. Kaunseling (individu dan /atau kelompok) serta terapi tingkah laku yang lain adalah komponen rawatan yang berkesan dan kritikal untuk penagihan. Dalam terapi, klien memberi perhatian terhadap isuisu motivasi, membina kemahiran untuk menolak penggunaan dadah, menggantikan aktiviti-aktiviti guna dadah dengan aktiviti-aktiviti yang konstruktif dan mengukuhkan aktiviti-aktiviti tidak guna dadah dan meningkatkan kemahiran menyelesaikan masalah. Terapi tingkah laku juga menggalakkan hubungan interpersonal dan mengembangkan kebolehan klien untuk berfungsi dalam keluarga dan masyarakat. Ubat-ubatan adalah unsur rawatan yang penting untuk kebanyakan klien, terutama apabila dikombinasikan dengan kaunseling dan terapi tingkah laku yang lain. Methadone dan Levo-alpha-acetylmethadol (LAAM) adalah berkesan dalam menolong penagih heroin atau opiateopiate lain untuk menstabilkan kehidupannya dan mengurangkan penggunaan dadah. Dari segi jangka panjang Naltrexone juga berkesan untuk membantu penagih-penagih mengurangkan keinginan terhadap dadah berasaskan opiate. Kedua-dua pendekatan rawatan ubat-ubatan dan terapi tingkah laku menjadi begitu penting untuk klien yang mengalami kecelaruan mental. 

Penagih dadah yang mengalami kecelaruan mental memerlukan dual-diagnosis dan perlu dirawat secara bersepadu. Oleh kerana kecelaruan penagihan dan mental sering dialami di kalangan orang yang sama, klien perlu dinilai dan dirawat atas kedua-dua patologi yang dialaminya. Medical detoxification hanya rawatan penagihan tahap pertama dan hanya sedikit sahaja menyumbang kepada perubahan penggunaan dadah jangka panjang. Detoksifikasi membantu klien menghilangkan gejala pengunduran dadah, tetapi detoksifikasi itu sendiri tidak cukup untuk membantu penagih dadah mencapai bebas dadah dalam jangka panjang. Namun demikian, bagi sesetengah klien ianya menunjukkan tanda awalan yang efektif untuk rawatan penagihan. Rawatan tidak semestinya bergantung kepada kesukarelaaan dan memerlukan kesediaan supaya berkesan. Tidak dinafikan motivasi yang kuat boleh mempercepatkan proses pemulihan. Namun begitu, sokongan, galakan dan gesaan keluarga, dorongan dan desakan majikan dan sistem perundangan jenayah boleh mendorong kemasukan untuk menjalani rawatan dan kejayaan intervensi pemulihan.

Kesan-kesan Buruk Dadah

1. Merosakkan sistem saraf pusat (otak & saraf tunjang) .

2. Dalam keadaan mabuk atau khayal , penagih tidak dapat mengawal pergerakan dan perimbangan badannya .

3. Risiko jangkitan HIV/AIDS , Hepatatis dan Sawan apabila menggunakan alat suntikan yang dikongsi .

4. Kesan ke atas wanita mengandung iaitu seperti keguguran , kelahiran bayi songsang , lahir belum cukup bulan , kematian bayi semasa lahir /melahirkan bayi yang tidak sempurna/cacat .

5. Melemah dan merosak daya pemikiran , pemahaman , percakapan , pengiraandan kebolehan menyelesaikan masalah .

6. Menyebabkan gangguan emosi dalam kehidupan keluarga dan masyarakat .

7. Peningkatan kes-kes sosial dan jenayah seperti budaya samseng , kecurian , rompakan , rogol , pembunuhan dan sebagainya . Ini adalah kerana penagih sebenarnya telah mengalami kerosakan otak dan mampu atau sanggup melakukan apa sahaja demi ketagihan mereka kepada dadah .

8. Membawa maut kepada : -

a. Diri sendiri

Contohnya :
Akibatnya daripada pengambilan dos yang berlebihan .

b. Ahli keluarga

Contohnya :
Ibu , kerana tindakan ganas/luar kawalan penagih kerana memerlukan wang untuk membeli dadah .

c. Orang awam

Contohnya :
Kemalangan akibat memandu di bawah pengaruh dadah .

Jenis-jenis Dadah

JENIS-JENIS DADAH

Dadah boleh dibahagikan kepada lima bahagian.

1.    Narkotik / Opait (Heroin, Morfin, Candu, Kodien & Metadon)

2.    Perangsang / Stimulants (Amfetamin, Methamfetamin, Ecstasy & Kokain)

3.    Penekanan / Depressants (Barbiturat, Trankuilizer, Alkohol)

4.    Hallucinogen (LSD, PCP, Meskalin, Psilosibin)

5.    Cannabis (Ganja, Hashish & Marijuana)

JENIS-JENIS DADAH YANG POPULAR PADA MASA KINI

1.      Morfin

Dikenali juga sebagai “M”, “White Stuff”, “White Powder”, “Monkey”, “Dreamer”, “Morpho”, “Tab”, “Morb”, “Cubes”, “Emsel” dan “Melter”. Morfin ialah sejenis alkaloid yang diperolehi dari candu mentah. Dalam pasaran gelap, ia selalunya diperolehi sebagai morfin mentah, bes morfin (morphine base) atau morfin sulfat atau morfin hidroklorid. Ia terdapat dalam bentuk blok, serbuk atau pil. Cara menggunakan morfin adalah dengan menyuntik larutan morfin atau menelan pil-pil morfin.

(Ini adalah contoh gambar yang di ambil dari laman google)

2.      Ganja

Ianya dikenali sebagai “Kanabis Herba”, “Marijuana/Grass”, “Pot/Weed”, “Bhang”, “Kif”, “Takrouri” dan “Dagga”. Kanabis herba atau ganja merujuk kepada bahagian daun dan pucuk berbunga pokok kanabis yang dikeringkan dan kadang-kadang dijadikan dalam bentuk blok atau ‘sate’. Ia menyerupai tembakau walaupun lebih kehijau-hijauan. Kandungan THC adalah antara 0.25%-8%.

(Ini adalah contoh gambar yang di ambil dari laman google)

3.      Kokain

Kokain berasal dari daun koka atau Erythroxylon coca dan lain-lain jenis pokok Erythroxylon yang terdapat di Peru, Bolivia, dan Colombia di pergunungan Andes, Amerika Selatan. Bahan ini kebanyakannya disalah gunakan di Amerika Syarikat.

The Anti-Drugs Campaigns' history

It seems like each year there is a new campaign to get you to stop messing up your brain with drugs. PSAs are shot out across the airwaves and papers beating up eggs and utilizing the glamour of celebrities. There are blogs popping up everywhere that poke fun at the sometimes humorous ads, but according to the CDC, drug use over the decades is down. In 1980, a group of high schoolers were asked if they used marijuana, cocaine or inhalants in the past month resulting in 33.7, 5.2 and 1.4 percents respectively; the same survey was conducted in 2007 resulting in a massive drop - 18.8, 2 and 1.2 percents respectively. As drug usage drops, ads are becoming more direct, more violent, and more dramatic. In the advertiser's defense, they are catering to a less receptive audience as time goes on. Take a look at the evolution of these ads over the decades.

1970's: Everybody's Doing It

During the decade of the 1970s, ads were PSA-based and incorporated less pop-culture than the 80s. Advertisers believed they could focus their attention on the feel-good agenda drug users would experience. The image to the left isEthan Persoff's scan of a weird anti-drug comic from 1970 called Users are Losers. In the 70's, one-third of the population of the United States, or 11 states, decriminalized small-quantity marijuana possession. It was a time where more than half of the population admitted to using in the previous month and one out of 10 people admittedly used at least once a day. In aUniversity of Nebraska report, only a third (35 percent) of American high school seniors believed that people who smoked marijuana regularly risked harming themselves. Today these ads would undoubtably be seen as government propaganda, depicting worse-case-scenarios and unbelievable side effects. They were focused on an emotional response, playing on the highs drug-users experienced and what they could expect their future. 

The 1936 cult classic Reefer Madness was the brunt of many jokes in the 70s. In 1971, the film was discovered by NORML founder Keith Stroup in the Library of Congress archives, and was purchased by Stroup for $297, then made it the gem of pot smokers and college campuses. Being that the film was originally funded by a church group with radical motives, the film quickly became ammo for drug users to discredit any anti-drug advertisements. 

Obviously targeting psychedelics to try to get people to avoid having a hallucinogenic experience doesn't make sense. Check out Hanna-Barbera's anti-drug PSA below, which I'm sure would be much more enjoyable high. Also watch this strange PSA with a magician who can "actually bend reality". 

 

1980's: Just Say No

Ah, how the era has changed. One president's wife spouts off about drugs and a whole country's attitude changes about MJ. In the mid-1980s, attitudes regarding drug use evolved from “acceptable and harmless” to “addictive and dangerous.” Celebs were popping up left and right with new ways to scare the public about using harmful drugs. Right. Because we should trust the man who spends all day in a colorful playhouse with a talking armchair, now sitting in a smokey room, to discuss the harmfulness of crack. Something's not quite right that in the seriousness of the topic, Peewee still finds in necessary to slick his hair down and flaunt the red bow tie.

Your Brain on Drugs

This is also the era of "This is Your Brain," the controversial anti-drug campaign that had egg enthusiasts in a tizzy. The campaign, lead by The Partnership for a Drug Free America, was coined "Fried Eggs" and ran well throughout the 80's. The “Fried Egg” TV spot was so well-known that it was parodied on shirts, posters, and even on Saturday Night Live. A decade later in 1997, a new version (this one focusing on snorting heroin) was created with actress Rachel Leigh Cook. Here are both versions: 

 

1990s: The Lost Generation

The early 1990s proved to us that fried eggs really make you not want to use drugs. In a joint study from Leading Business School Professors at Yale SOM, NYU Stern, London Business School, and Baruch had these findings in 2002: "Anti-Drug Advertising Works... This study evaluated the effectiveness of drug-education messages from the PDFA from 1987 to 1990, measuring whether the advertising campaign was associated with a change in adolescents' drug use. The research findings suggest that by 1990 - after three years of anti-drug television advertisements - drug use was reduced by approximately 9%. Additionally, the team observed that the decrease in drug consumption came at a time when anti-drug ads had increasing levels of national media exposure and public visibility. During this timeframe, pro bono media support for anti-drug advertising increased from a low of $115 million in 1987 to a high of $365 million in 1991." Unfortunately, the 90s didn't do such a good job keeping people off drugs after the 80s ushered in some sober individuals. In the early 1990s, research shows that the National Youth Anti-Drug Media Campaign launched in order encourage young people to stay away from drugs "is unlikely to have had favorable effects on youths." 

What's even better: skeptics claim the anti-drug ads, a $1 billion effort, may have had a reverse effect and actually caused more teenagers to use drugs. Robert Hornik, professor of communication at the University of Pennsylvania, researched the campaign in 2004 and concluded the ads “either had no effects on kids or possibly had a boomerang effect.” The failed campaign tried to compare users to non-users, suggesting that your friends that used sucked and you were right to not use; however non-users were more concerned that their peers were doing something they weren't. Another study on the same topic mentions that "in turn, those who came to believe that their peers were using marijuana were more likely to initiate use themselves." 

It is what you'd expect, though, when running unlikely scenarios of minors facing intense situations from bullies in high-tops. There's more wrong in the video below than just cartoon turtles having a dialog with a kindergarten class, who would otherwise have no idea that drug use should be one of their concerns: 

2000s: We'll Get it Right Next Time

If comparing them won't work, fear will. The Montana Meth project has been running a campaign for years linking meth to horrid scenarios. The ads are counting on viewer's shock-value and are causing quite the controversy. The above ad, featuring a female meth user unaware of her decisions, in an implied sex position with a man who is almost completely out of frame. The billboard reads "15 bucks for sex isn't normal. But on meth it is." In response from parents organizations, the Montana Meth Project has agreed to pull this particular billboard, but still has several others reliant on the same shock value. 
Messages like these are awfully strong for an outdoor campaign, especially in a rural area. According to a local newspaper, however, some Montanans want the ads to continue, crude content and all. One comment on the story: "Meth is a terrible thing. Perhaps these parents can figure an appropriate explanation to their children. Some people need to be shocked." Shocked seems to be the trends of this decade, even internationally. With an emerging global economy, we're exposed to all sorts of drugs drugs in all new ways. Estadao.com.br, a Brazilian publication, had this finding: 

"Drug (cocaine) had been diagnosed in 80% of the nations of the world, indicating that the globalization of trade has become a problem. For years, consumers around the world [snort] 600 tons of cocaine, with a turnover of approximately R $ 80 billion. For Brazil, moving 80 tons a year, almost all produced in neighboring countries like Colombia, Peru and Bolivia. The drug trafficking brings in about $ 5 billion in Brazil."

Anti-Drug supporters are fighting back, with similar campaigns like the Montana Meth Project - shocking, graphic and vivid. Here's a translated version of a commercial that ran in New Zealand: 

Turning the Light on Crack Heads

In order to be effective, drug advertising can't be related to people you really know. Telling teenagers that all their stupid friends are doing drugs only makes them want to shoot up. But research shows people don't actually want to be doped up and raped in a ditch. Why it took 4 decades for us to figure that out is beyond this blog. With wider varieties of drugs, easier ways to get them, and far better trips than our ancestors could have dreamed of, anti-drug supporters are finding more clever ways to engage their hopefuls. Their messages are getting louder, and the numbers show that they are being heard.